Provider Demographics
NPI:1376718304
Name:MIKE DEE ALLEN,D.D.S.,M.S.D.,INC.
Entity Type:Organization
Organization Name:MIKE DEE ALLEN,D.D.S.,M.S.D.,INC.
Other - Org Name:DRS. ALLEN & ALLEN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:DEE
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS,MSD
Authorized Official - Phone:972-414-5530
Mailing Address - Street 1:3046 LAVON DR
Mailing Address - Street 2:SUITE 112
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75040-8794
Mailing Address - Country:US
Mailing Address - Phone:972-414-5530
Mailing Address - Fax:
Practice Address - Street 1:3046 LAVON DR
Practice Address - Street 2:SUITE 112
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-8794
Practice Address - Country:US
Practice Address - Phone:972-414-5530
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-30
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX83951223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty